Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios can Predict Treatment Response to Neoadjuvant Therapy in Esophageal Cancer

Patrick J. McLaren, Nathan Bronson, Kyle D. Hart, Gina Vaccaro, Ken M. Gatter, Charles R. Thomas, John G. Hunter, James Dolan

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Introduction: We hypothesized that serum neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios may predict pathologic complete response to neoadjuvant chemoradiotherapy in esophageal cancer patients. The ability to predict favorable treatment response to therapy may aid in determining optimal treatment regimens. Materials and Methods: A retrospective review of a prospective esophageal disease registry was conducted. Neutrophil-to-lymphocyte ratio was defined as the pre-chemoradiotherapy serum neutrophil count divided by lymphocyte count. Platelet-to-lymphocyte ratio was similarly defined. Logistic regression was applied to analyze these ratios and their effect on pathologic complete response. A Cox proportional-hazards model was used to analyze survival. Results: Sixty patients were included. Elevated neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were both negative predictors of pathologic complete response (odds ratio: 0.62; 95% confidence interval: 0.37–0.89, P = 0.037 and odds ratio: 0.91; 95% confidence interval: 0.82–0.98, P = 0.028, respectively). Only platelet-to-lymphocyte ratio was predictive of decreased overall survival (hazard ratio: 1.05, 95% confidence interval: 0.94–1.16, P = 0.40). Conclusion: Elevated neutrophil and platelet-to-lymphocyte ratios were significant predictors of a poor treatment response to neoadjuvant therapy. Only elevated platelet-to-lymphocyte ratio was predictive of worse overall survival. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios may offer a simple serum test to assess the likelihood of a pathologic complete response after neoadjuvant therapy in esophageal cancer.

Original languageEnglish (US)
Pages (from-to)607-613
Number of pages7
JournalJournal of Gastrointestinal Surgery
Issue number4
StatePublished - Apr 1 2017


  • Esophageal cancer
  • Neutrophil-to-lymphocyte ratio
  • Oesophageal cancer
  • Pathologic complete response
  • Platelet-to-lymphocyte ratio

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology


Dive into the research topics of 'Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios can Predict Treatment Response to Neoadjuvant Therapy in Esophageal Cancer'. Together they form a unique fingerprint.

Cite this